title: Antiviral treatment for hepatitis B virus recurrence following liver transplantation.
abstract: The purpose of this study was to identify the factors associated with the recurrence of hepatitis B virus (HBV) following liver transplantation (LT) for HBV-related disease and to recognize the outcome of treatment for HBV recurrence with oral nucleos(t)ide analogues. Six hundred and sixty-seven LTs were performed for HBsAg-positive adult patients in our institute from 1996 to 2010. HBV prophylaxis was performed by hepatitis B immunoglobulin (HBIG) monotherapy or HBIG and entecavir combination therapy. There were 63 cases (11.4%) of HBV recurrences during a median follow-up of 51 months. The median time to HBV recurrence was 22 months. A preoperative HBV DNA load of more than 10(5) IU/mL, HBIG monotherapy, and hepatocellular carcinoma in the explant liver were independent risk factors for HBV recurrence following LT in multivariate analysis. Patient survival at 10 yr was 54.2% for HBV-recurrent patients. Among patients with HBV recurrence, HBsAg seroclearance was achieved in 13 patients (20.6%), but HBsAg seroclearance did not affect survival in these patients after the recurrence of HBV (p = 0.28). The recurrence of HBV led to graft failure in six cases. HBV recurrence should be prevented by strict management of pre-transplant HBV viremia and an effective post-transplant HBV prophylaxis.
authors.affiliation: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Sanghoon
authors.initials: S
authors.lastname: Lee
authors.forename: Choon Hyuck D
authors.initials: CH
authors.lastname: Kwon
authors.forename: Hyung Hwan
authors.initials: HH
authors.lastname: Moon
authors.forename: Tae-Seok
authors.initials: TS
authors.lastname: Kim
authors.forename: Youngnam
authors.initials: Y
authors.lastname: Roh
authors.forename: Sanghyun
authors.initials: S
authors.lastname: Song
authors.forename: Milljae
authors.initials: M
authors.lastname: Shin
authors.forename: Jong Man
authors.initials: JM
authors.lastname: Kim
authors.forename: Jae Berm
authors.initials: JB
authors.lastname: Park
authors.forename: Sung Joo
authors.initials: SJ
authors.lastname: Kim
authors.forename: Jae-Won
authors.initials: JW
authors.lastname: Joh
authors.forename: Suk-Koo
authors.initials: SK
authors.lastname: Lee
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000150:complications; D004279:DNA, Viral / Q000235:genetics; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006147:Guanine / Q000031:analogs & derivatives / Q000627:therapeutic use; D006509:Hepatitis B / Q000175:diagnosis / Q000188:drug therapy* / Q000821:virology; D006515:Hepatitis B virus / Q000235:genetics / Q000472:pathogenicity*; D006801:Humans; D007136:Immunoglobulins / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000150:complications; D016031:Liver Transplantation; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D055502:Secondary Prevention; D015996:Survival Rate
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D007136:Immunoglobulins; C413685:entecavir; D006147:Guanine; C045213:hepatitis B hyperimmune globulin
keywords: HBV recurrence; antiviral therapy; hepatitis B virus; liver transplantation